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Review
. 2017 Apr 27;2(4):104-109.
doi: 10.1302/2058-5241.2.160023. eCollection 2017 Apr.

Periprosthetic shoulder infection: an overview

Nicolas Bonnevialle  1 , Florence Dauzères  2 , Julien Toulemonde  2 , Fanny Elia  2 , Jean-Michel Laffosse  3 , Pierre Mansat  1
Affiliations
Review

Periprosthetic shoulder infection: an overview

Nicolas Bonnevialle et al. EFORT Open Rev. .

Abstract

Periprosthetic shoulder infection (PSI) is rare but potentially devastating. The rate of PSI is increased in cases of revision procedures, reverse shoulder implants and co-morbidities. One specific type of PSI is the occurrence of low-grade infections caused by non-suppurative bacteria such as Propionibacterium acnes or Staphylococcus epidemermidis.Success of treatment depends on micro-organism identification, appropriate surgical procedures and antibiotic administration efficiency. Post-operative early PSI can be treated with simple debridement, while chronic PSI requires a one- or two-stage revision procedure. Indication for one-time exchange is based on pre-operative identification of a causative agent. Resection arthroplasty remains an option for low-demand patients or recalcitrant infection. Cite this article: EFORT Open Rev 2017;2:104-109. DOI: 10.1302/2058-5241.2.160023.

Keywords: Propionibacterium acnes; arthroplasty; infection; revision; shoulder.

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Conflict of interest statement

ICMJE Conflict of interest statement: NB reports he is a consultant for Wright, Smith & Nephew and Stryker. PM reports that he receives personal fees from Wright, Smith & Nephew and Synthes. All other authors declare no conflict of interest.

Figures

Fig. 1
Fig. 1
a) Radiograph of a 73-year-old man with a chronic periprosthetic shoulder infection of a reverse shoulder arthroplasty (RSA). b) A two-stage revision was decided with a cement spacer implantation for eight weeks. c) Propionibacterium acnes was identified on peri-operative samples taken from the back of the glenosphere. d) After four weeks free of antibiotics, a new RSA was implanted with a proximal humeral allograft.
Fig. 2
Fig. 2
Radiographs (a and b) of an 86-year-old woman, with a loose implant secondary to chronic periprosthetic shoulder infection. c) Because of numbers of co-morbidities and huge bone loss on glenoid side, a simple resection arthroplasty was performed.
See this image and copyright information in PMC

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